Edrich T, Riener R, Quintern J
Department of Neurology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Germany.
IEEE Trans Biomed Eng. 2000 Aug;47(8):1058-65. doi: 10.1109/10.855933.
In the functional electrical stimulation of the lower extremity of paraplegics to achieve standing and walking, a mathematical model describing the passive elastic joint moments is essential in order to implement model-based control algorithms. In a previous investigation of ten normal persons we had found significant coupling of passive, elastic joint moments between neighboring joints due to muscle groups that span both joints (biarticular muscles). Thus, we now investigated the biarticular coupling in six paraplegic patients. A comparison to the averaged results of the ten normal persons showed that while the biarticular joint moment coupling due to the gastrocnemius muscle was well preserved in all patients, the coupling due to the rectus femoris was greatly reduced and the coupling due to the hamstring muscle group was negligible. We offer pathophysiologically based explanations for these characteristic differences including the speculation that the predominantly extensor-type spasticity in our patients exercises mainly the anti-gravity muscles such as the gastrocnemius and the rectus femoris, while permitting greater atrophy of the hamstring muscle group. A previously presented double-exponential equation that predicts the joint moments under consideration of the neighboring joint angles could be fitted well to the experimental data.
在对截瘫患者下肢进行功能性电刺激以实现站立和行走的过程中，为了实施基于模型的控制算法，描述被动弹性关节力矩的数学模型至关重要。在之前对10名正常人的研究中，我们发现由于跨越两个关节的肌肉群（双关节肌肉），相邻关节之间存在显著的被动弹性关节力矩耦合。因此，我们现在对6名截瘫患者的双关节耦合情况进行了研究。与10名正常人的平均结果相比，发现虽然所有患者中腓肠肌引起的双关节力矩耦合保存良好，但股直肌引起的耦合大大降低，而腘绳肌群引起的耦合可忽略不计。我们从病理生理学角度对这些特征差异进行了解释，包括推测我们的患者中主要的伸肌型痉挛主要锻炼了诸如腓肠肌和股直肌等抗重力肌肉，同时使腘绳肌群出现更大程度的萎缩。之前提出的一个考虑相邻关节角度来预测关节力矩的双指数方程能够很好地拟合实验数据。
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